Insomnia
Insomnia is a common sleep disorder that can make it hard to fall asleep or stay asleep. It also can cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can drain your energy level and affect your mood. It also can affect your health, work performance and quality of life.
How much sleep is enough varies from person to person. But most adults need 7 to 9 hours a night.
At some point, many adults have short-term insomnia. This can last for days or weeks. Short-term insomnia is usually due to stress or a distressing event. But some people have long-term insomnia, also called chronic insomnia. This lasts for three months or more. Insomnia may be the main problem, or it may be related to other medical conditions or medicines.
What causes insomnia?
Insomnia has many possible causes. They may include any or all of these:
- Medicines that interfere with sleep
- Dietary choices that interfere with sleep, such as having caffeine late in the day
- Stressful thoughts
- Depression
- Recent upheavals in your life, such as moving, job loss, divorce, or death of a loved one
- Hormone changes, such as those accompanying menstrual cycle, pregnancy, and menopause
- Bedtime habits that don’t lead to restful sleep
- Sleep disorders, such as restless leg syndrome and sleep apnea
- Chronic pain
- Medical conditions, such as acid reflux, thyroid problems, stroke, or asthma
- Substances like alcohol and nicotine
- Travel, especially between time zones
Insomnia and aging
Insomnia becomes more common with age. As you get older, you may:
- Change your sleep patterns. Sleep often becomes less restful as you age, so noise or other changes in your surroundings are more likely to wake you. With age, your internal clock often moves forward in time, so you get tired earlier in the evening and wake up earlier in the morning. But older people typically still need the same amount of sleep as younger people.
- Change your level of activity. You may be less physically or socially active. A lack of activity can disrupt a good night’s sleep. Also, the less active you are, the more likely you may be to take a daily nap. Napping can disrupt sleep at night.
Have changes in your health. Ongoing pain from conditions such as arthritis or back problems, as well as depression or anxiety, can disrupt sleep. Issues that make it more likely that you’ll need to urinate during the night, such as prostate or bladder problems, can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.
Take more medicines. Older people typically use more prescription drugs than younger people do. This raises the chance of insomnia related to medicines.
Complications
Sleep is as important to your health as a healthy diet and regular physical activity. Whatever is keeping you from sleeping, insomnia can affect you mentally and physically. People with insomnia report a lower quality of life compared with people who sleep well.
Complications of insomnia may include:
- Lower performance on the job or at school.
- Slowed reaction time while driving and a higher risk of accidents.
- Mental health conditions, such as depression, anxiety or substance misuse.
- Higher risk or worsening of long-term diseases or conditions, such as high blood pressure and heart disease.
Prevention
To help ensure that you can fall asleep when you want to—and stay asleep for the quality rest you need—make sleep a priority in your life.
Set aside time for sleep. Keep your cycle of sleeping and wakefulness steady throughout the week, including the weekends, recommends Salas. While most people need 7 to 9 hours of sleep at night, keeping a consistent cycle may be even more important than quantity, she says. Set a bedtime and a wake-up time for yourself, and stick to it.
Get your brain ready for sleep. You can’t make your brain fall asleep on command as if you were stepping on the brakes to stop your car, says Salas. Instead, your brain needs help shifting to sleep. Be sure to follow these recommendations:
- Establish a presleep ritual before bed. For example, taking a shower and putting on sleepwear might signal your brain that you’re heading to bed.
- In the evenings, avoid activities that can keep you awake, like drinking coffee, soda, or other caffeinated drinks; smoking; exercising; and eating heavy meals.
- Give your brain time to unwind. If you need to pay bills or settle an argument, do it during the day, not at bedtime.
- Avoid light in the late evening. Shut off your electronic devices at least 30 minutes before bedtime. Light keeps your brain primed for wakefulness.
How is insomnia treated?
You have many choices for treatment:
- Change in lifestyle choices that may interfere with sleep
- Better-sleep bedtime habits, called sleep hygiene
- Change in existing medicine if that’s what’s causing the problem
- Counseling to help relieve stress and other issues bothering you
- Medicines to help you get to sleep and stay asleep. These are used with caution, especially for older adults
The exact course will depend on what your healthcare provider identifies as the possible causes of your insomnia.
